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15505 (PLBG)N Building Address 52-229 A. T4'ht P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Owner aI David Harbison Address 52-220 Ave Rubio City Zip Tel. La Quinta 92253 Contractor Dateland Construction Co,, Inc. Aaaress 50-345 WY 111 City Zip Tela Coachella 92236 398-5544 State Lic. City & Classif. 396698 C--42 I Lic. # 31 Arcn., tngr., I Designer Address Tel. City (Zip (State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) t.of Division 3 of the Business and Professions Code, and my license is in full force and effec SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). 0 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or Improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) O I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and .Professions Code: The Contractor's License Law does not apply to an. owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) ((tensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION T. hereby affirm that I have a certificate of consent to self -insure, or a certificate of Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy. No. Company ❑:Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed If the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thF work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become Subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. WARNING: FAILURE TO SECURE WORKERS' COMPENSATIONCOVERAGE IS UNLAWFUL, AND`, SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE > HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ' This is a building permit when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the . above-. mentioned property for inspection purposes. Signature of applicant -Date- Mailing aleMailing Address City, State, Zip No.15545 WING: TYPE CONST. OCC. GRP. P. Number Legal Description Lot 22 81k 10 Project Description Abandon Septic & hook Up Sewer S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line =======-Setback from Center Line 0�_ Side'Setbl ck from Property Line FINAL DATE ` �Zq - -) III 1 INSPECTOR Issued by: "' y + ©ate�I Permit lu Validatpo by: Validation: Sq. Ft. Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $2,000.00 i PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. • �tJ Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line =======-Setback from Center Line 0�_ Side'Setbl ck from Property Line FINAL DATE ` �Zq - -) III 1 INSPECTOR Issued by: "' y + ©ate�I Permit lu Validatpo by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIW FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SO. FT. FORMS OR ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (ROUGH) METER LOOP GAR. SO. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SO. FT. ® GROUT WATER HEATER WALL SO. FT. ® FINAL INSP. DRINKING FOUNTAIN BOND BEAM WATER SYSTEM URINAL SO. FT. ® -$ LUMBER GR. ESTIMATED CONSTRUCTION VALUATION $ FRAMING WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES REMARKS: WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE,TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB MESH SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL FINISH GRADING SO.FT.GAR ® 3/4c HOUSE SEWER FINAL INSPECTION GAS PIPING PERMIT FEE CERT. OCC. PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS OR ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING CU. yd. $ plus x$ -$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESJINITIALS GARDEN WALL FINAL COACHELLA VALLEY WATER DISTRICT a4�.pt jt ,CASH RECEIPT DETAIL Received Froin: te' ` �� (� �S'U y ` ) Da '* Address: ( Account No.3q<-0,0Loj(s) , �Y \O Trecl_ Cit, Service Address G.A. Code. ❑ Meter(s) S ' O Service(s) ❑ Backllow(s) S O House Lateral(s) O Detector Check(s) O7ter Surcharge Sanitation Capacity Charge O W.S.B.F.C. - O Temporary Construction Meter O Turn on Charge O Uncollected Account - Name ❑ Inspection Fee - Tract - 'a Fee - O Plan Check Fees Water / Sewer - ' Tract - S O Bond Payment - A.D. - Bonde. '? Assmt O Customer Deposit O Ovier s Remarks: ❑Copy to: Check �✓ Money Order N TOTAL S� l u U, Water Service Cashier CVWD-438 t-; JOB INVOICE HAMMER PUMPING INC. P.O. Box 2448 CATHEDRAL CITY, CALIFORNIA 92235-2448 &19% '3&^ TAA o �V 1.7/ JVV-I TTVCUSTOMER'S (619) 321-7448 DESCRIPTION OF MATERIAL USED ORDER N0. D E OR77 1- —WSJ ORDER TAKEN BY DATE PROMISED ❑ A.M. ❑ P.M. BILL TO. L e <A l O N� ( PHONE ADDRESS Pumping Fee per 1000 gal. MECHA�IhC , CITY HELPER JOB NAMEjtIV yLOCATION UA lJ (, 60b Dumping Fee per 1000 gal. 'k -AY WORK /❑•_CONTRACT DESCRIPTIO F WORK O EXTRA 7 obi ! C Out of Area Fee .. QUANT. DESCRIPTION OF MATERIAL USED PRICE AMOUNT I tS7� .. Gallons 6� Pumping Fee per 1000 gal. S 60b Dumping Fee per 1000 gal. Out of Area Fee Locating / Opening Fee (per hour) - Size System: A SERVICE CHARGE OF $20 Wif L BE DUE ON ALL RETURNED CHECKS. ' A FINANCE CHARGE OF 11/2% PER MONTH, 18% PER YEAR WILL BE CHARGED ON PAST DUE ACCOUNTS OVER 30 DAYS. HOURS LABOR AMOUNT TOTAL MATERIALS MECHANICS Q TOTAL --LABOR HELPERS I hereby acknowledge the satisfactory TOTA LABOR COMp etior(of the above descri a TAX SIGN;;DATE COMPLETED fj�,�✓v t TOTAL S ' Under the California`Mechanics Lien Law any contractor, subcontractor, laborer; supplier or other person who helps•to improve your property; but is not paid for his/her work or supplies, has a right to enforce a claim against your property. This means that after a court hearing, your property could be sold by a court officer and the proceeds of the sale used to satisfy the indebtedness. This can' happen even if you have pald,your, contractor in;full if the subcontractors, laboreis or suppliers remain unpaid. To preserve their right to file a claim or lien against your property, certain claimants such as subcontractors or material suppliers are required to provide you with a document entitled "Preliminary Notice." Original (or prime) contractors and laborers for wages do not have to - provide this notice. A Preliminary Notice is not a lien against your property. Its purpose•is to notify you of persons who may have a right to file a lien against your property If they are not paid. Generally, the maximum time allowed for filing a claim or lien against your property is ninety (90) Days after completion of your project. TO INSURE EXTRA PROTECTION FOR YOURSELF AND YOUR PROPERTY, ^� YOU MAY WISH TO TAKE ONE OR MORE. OF THE FOLLOWING STEPS, 1) Require that payments be made directly to subcontractors and material suppliers through ; a joint control. Any joint control agreement should include the addendum approved by the Registrar of Contractors 2) Issue joint checks for payment, made out to both your contractor and subcontractors or material suppliers involved in the project. This will help to insure that alt persons due payment are actually paid. 3) After UPON making payment on any completed phase bf the project, and before making any further payments, require your contractor to provide you with unconditional lien releases signed by each material supplier; subcontractor and. laborer involved in that portion of the work for which payment was made. On projects involving improvements to a single family residence or a duplex owned by Individuals, %e persons -signing these releases lose the right ; to file a claim against your property. In other types of construction this protection may still be important, but array not be as complete. TO PROTECT YOURSELF UNDER THIS OPTION YOI I MUST BE CERTAIN THAT ALL MATERIAL SUPPLIERS, SUBCONTRACTORS OR LABORERS. - HAVE SIGNED. ,:i